The issues related to the country specific implementation of the intervention might explain some of the variation between the countries. However, this study suggests that large country variations in feeding were present from birth. For example, it is known that formula feeding had a high acceptance in South Africa [34], whereas this is not the case in Uganda and Burkina Faso and large areas of sub-Saharan Africa where it is considered unaffordable, unacceptable and unfeasible [35]. Women in Burkina Faso and Uganda might thus have been more motivated to breastfeed than in South Africa.